No abstract

Both isoflurane and sevoflurane delivered at 1 MAC for 4 h to immature rats caused a deficit in long-term memory. Isoflurane also caused a deficit in short-term memory. Isoflurane might be more detrimental than sevoflurane in very young animals.

Childhood obesity is a public health threat that disproportionally affects Latino youth in the United States. Active and Healthy Families (AHF) is a culturally tailored, family-based program for addressing obesity disparities in a predominantly immigrant Latino population. AHF was the first primary care, culturally tailored intervention for Latino children to significantly reduce BMI in a randomized controlled trial. The 10-week AHF intervention reduced BMI (kg/m) among overweight or obese children by 0.5, compared with an increase of 0.3 in the control group, yielding a -0.8 difference ( p < .01). A unique aspect of the program is its provider team: a physician, dietitian, and promotora. Because early feedback from families highlighted the importance of promotoras specifically, we sought to understand the unique mechanisms of promotora effectiveness in AHF. We conducted in-depth, semistructured interviews with the AHF providers ( n = 5) and parent participants ( n = 23) by phone between November 2012 and May 2013. In a grounded theory analysis, three main categories encompassing five themes emerged: (a) bridging communication by promotoras; (b) promotoras' personal qualities, including themes of kindness and caring and shared experiences with patients; and (c) impactful task performance, including themes of motivation, positive environment, and self-efficacy. Together, the themes serve as the basis of a conceptual model illustrating the process through which promotoras may enhance the impact of team-based obesity programs for the Latino community. Because this study identifies the specific ways through which promotoras can bridge cultural, linguistic, and other divides, it may inform development and dissemination of evidence-based approaches for obesity prevention in the Latino community.

Massachusetts' abortion parental consent law is associated with clinically significant delays, which may constrain options available for the clinical management of minors undergoing abortion.

(Abstracted from Obstet Gynecol 2019;133:978–986) Thirty-seven states mandate parental consent or notification before providing abortion care to minors. In Massachusetts' parental consent law, a minor (17 years old or younger) requires parental approval before a legal abortion is permitted, but parental involvement can be bypassed through some mechanism, such as a petition to a judge (“judicial bypass”).

This strategic alliance succeeded in promoting district-level priority and funding for PE. Ongoing alliance work will focus on increasing accountability measures for PE, which may take longer to implement.

No abstract

Prenatal lifestyle intervention studies that limit gestational weight gain (GWG) have largely failed to reduce the rate of gestational diabetes mellitus (GDM), suggesting that prenatal interventions may be too late to provide benefit. The objective of this study was to determine the independent association of periconceptional diet quality on gestational glycemia and frequency of GDM. STUDY DESIGN: This is a secondary analysis of 9566 nulliparous pregnant women from the nuMoM2b cohort with a GDM classification (yes/no), and a subset of 1323 women with available data from a 3-hr 100g glucose tolerance test (GTT) at a mean gestational age of 28.7AE7.2 weeks. Subjects reported their usual dietary intake over the preceding 3 months by food frequency questionnaire in early pregnancy (6-13 weeks). The Alternative Healthy Eating Index (AHEI)-2010 was computed as a continuous index score of periconceptional diet quality. Logistic regression was used to estimate the association between the AHEI score and odds of GDM. The association between the AHEI score with each hourly GTT result was tested in separate linear regression models. All models were adjusted for confounding factors (maternal age, self-identified race/ethnicity, pregravid body mass index (BMI), smoking) and a sensitivity analysis was performed with additional adjustment for rate of GWG per week. RESULTS: The mean pregravid BMI among those eligible for inclusion was 26.3AE6.3 kg/m 2 and 46% were overweight or obese. The GDM frequency was 4.1% overall and 21.3% among those who underwent a 3-hr GTT. Higher diet quality was associated with a reduced risk of GDM (beta¼-0.02, p¼0.004, OR¼0.98, 95% CI 0.97-0.99). Diet quality was inversely associated with blood glucose values at each GTT measurement (Table 1). Additional adjustment for rate of GWG did not alter the significant results. CONCLUSION: After accounting for confounding factors and GWG, poor periconceptional diet quality remained a risk factor for elevated GTT values and GDM in a diverse cohort of nulliparous women. Periconception intervention studies targeting women's diet quality are warranted.